[Duodenal polyps of gastric origin]

Recently, thanks to the collected knowledge and increased diagnostic abilities we more often meet the diseases that have been considered very seldom. Beside that, we form the new assumptions that must be proved. Today, more often we meet gastric mucosa in duodenum. That according to some researchers, introduces a real possibility for appearance of the polyps, ulcers or cancer on gastric substratum. In the subject patient the two polyps of the gastric origin were found in a duodenum. That could support the assumption that ectopic gastric mucosa presents one of the real possibilities for appearance of polyps, ulcers and cancer.

Demonstration of perycriptal fibroblasts in inflammatory-regenerative and dysplastic epithelial lesions of the flat colonic mucosa

The aim of the paper is the definition of perycriptal fibroblasts (PCFs) distribution in inflammatory-regenerative and dysplastic epithelial lesions of flat bowel mucosa. The relationship between the presentation of PCFs and the grade of inflammatory-regenerative and dysplastic process in the flat colon mucosa is also examined. Biopsy specimens from 270 patients were examined: 74 were classified as inflammatory-regenerative and 196 as dysplastic lesions (108 mild, 58 moderate, and 30 severe dysplasia). The demonstration of PCFs in biopsy specimens was performed by immunohistochemistry using monoclonal antibody for alpha smooth muscle actin, muscle-specific actin (HHF-35), vimentin and desmin, in comparison with normal mucosa and adenocarcinoma. The PCFs were reduced in inflammatory-regenerative and dysplastic mucosa. The reduction was significantly related with the grade of epithelial dysplasia. The carcinomas tended to lack PCF network. During inflammatory-regenerative and dysplastic process in flat bowel mucosa, PCFs express alpha smooth muscle actin, muscle specific actin, vimentin and desmin, showing the phenotypical growing expression of potentially present smooth muscle differentation features of fibroblasts. These findings suggest that the reduction of PCFs in dysplastic epithelial lesions may relate to the development of dysplasia in flat bowel mucosa. Reduced number of PCFs in dysplastic mucosa may be a marker for the risk of preneoplastic and neoplastic progression in bowel mucosa.

[Effect of pantoprazole, amoxicillin and metronidazole treatment on the level of H. pylori eradication and the histological image of antral gastritis in patients with duodenal ulcer]

BACKGROUND

Relationships between Helicobacter pylori infection, inflammatory changes in antral region of gastric mucosa, and duodenal ulcer is well known and documented in a large number of studies. This trial is designed to examine effect of one week regimen of Pantoprazole, Amoxycillinum and Metronidazol to eradication of H. pylori, duodenal ulcer healing and histological changes on gastric mucosa.

PATIENTS AND METHODS

30 patients with active duodenal ulcer, H. pylori-positive, 16 male, with average age 47.12 +/- 13.13 yrs (AVG +/- STD) and 14 female patients with average age 44.47 +/- 12.29 yrs were included in trial. Biopsy of gastric antral region were performed in each patient. Patients were given Pantoprazole 40 mg bid, Amoxycillinum 1000 mg bid, Metronidazolum 500 mg bid for 7 days. After 7 days of treatment, control endoscopy was performed with repeated rapid ureasa test for H. pylori and antral biopsy and with verification of duodenal ulcer healing. Patients were followed up for 24.3 +/- 9.7 weeks for occasion of subjective symptoms.

RESULTS

96.67% patients were presented with eradicated H. pylori, complete ulcer healing was found in 83.34% patients after one week regimen (13.33% patients with ulcer reduced on one third of previous described), 73.33% of patients were presented with histologically feature of chronic gastritis turned from active to stationary phase.

CONCLUSION

One week regiment with Pantoprazole, Amoxycilline and Metronidazole is effective, and beside a high rate ulcer healing and eradication of H. pylori it provides an improvement of histological feature of antral gastritis.

Tryptase: The Silent Witness of Past and Ongoing Systemic Events

Introduction: Tryptase is an important biomarker widely used in the laboratory confirmation of severe hypersensitivity reactions, especially anaphylaxis. It also plays a crucial role in the diagnosis, risk stratification, management and prognostic evaluation of many other mast cell-related conditions. Aim: This paper aims to highlight the role of serum tryptase, both in allergic disorders and other mast cell-related conditions. Two clinical cases regarding timely serum tryptase acquisition (in drug hypersensitivity reactions during the imaging procedure and perioperative anaphylaxis) are meant to emphasize the clinical potential of this protease. Method: We performed a comprehensive literature search of the PubMed/Medline and Scopus databases. From a total of 640 subject related publications, dating from 1940 to 2024, 45 articles written in English were selected. Literature search results: Total serum tryptase is a simple, cost-effective analysis with a normal baseline tryptase (sBT) level below 8.4 µg/L. Elevated sBT can indicate hereditary alpha-tryptasemia (HαT), mastocytosis and other non-allergic disorders. Patients with higher sBT levels, especially with insect venom allergy, have an increased risk of severe reactions and thereby require a prolonged treatment. All immediate systemic hypersensitivity reactions require a correlation between serum acute tryptase (sAT) and sBT. According to the guidelines, measuring sAT 30 min to 2 h after the symptom onset and sBT 24 h after the resolution, using the 20 + 2 rule and an sAT/sBT ratio of 1.685, improves the diagnostic accuracy in anaphylaxis. Conclusions: Tryptase levels should be acquired in all cases with clinical suspicion of MC degranulation. Given the increasing clinical relevance, elevated baseline serum tryptase levels require a multidisciplinary approach and further investigation.

[Protective effect of zinc in chromium poisoning in rats]

The effect of a toxic trivalent chromium dose on histopathological changes in rat organs was investigated. To evaluate a protective effect of zinc, rats were treated with ZnCl2 two hours before chromium administration. The protective zinc action was best observed in respect to morphological changes in the organs of chromium poisoned rats, particularly in the liver. The lack of areas of focal necrosis on the liver capsule in the protected group of rats was the most evident macroscopic findings. The histopathological changes observed were in accordance with the results of own previous investigation of the changes in lactate dehydrogenase activity in rat organs induced by chromium and zinc. The mechanisms of the zinc protective effect against chromium poisoning are discussed.

Early Dalmatian farmers specialized in sheep husbandry

The spread of farming in the central and western Mediterranean took place rapidly, linked to the Impressa Ware. The Impressa Ware originated somewhere in the southern Adriatic and spread westwards across the Mediterranean. These early farmers had an economy based on cereal agriculture and caprine husbandry, but there is still little information on how this agropastoral system functioned. This study aims to unravel the farming practices of the early Dalmatian farmers linked to the Impressa culture by using an integrated analysis, combining archaeozoology, palaeoproteomics and stable isotopes, applied to the faunal assemblages of Tinj-Podlivade and Crno Vrilo. The results show: (1) the composition of the flocks was overwhelmingly sheep; (2) sheep exploitation at both sites was similar, focusing on milk and meat; (3) sheep reproduction was concentrated at the beginning of winter, with no reproduction in autumn as in later sites in the western Mediterranean. We conclude that a common animal economy existed at both sites, which could be related to the mobility practiced by these early farming societies throughout the Mediterranean.

Carcinoembryonic antigen (CEA) in colonic inflammatory-regenerative and dysplastic epithelial lesions

AIM

Immunohistochemical study of carcinoembryonic antigen (CEA) distribution in inflammatory-regenerative and dysplastic changes of bowel mucosa. The relationship between the presentation of CEA and the intensity of inflammatory-regenerative and dysplastic processes in the flat colon mucosa was also examined.

METHODS

Biopsy specimens from 105 patients were examined: 45 classified as inflammatory-regenerative and 60 as dysplastic (21 mild, 23 moderate, and 16 severe dysplasia). The expression of CEA was assessed on the basis of location, quantity, and intensity of CEA immunostaining, by counting antigen-positive cells, and the presence of antigen in the lumen of crypts and glycocalyx on the surface of the mucosa. Using a semiquantitative method, antigen staining intensity was defined as weak, moderate, and intense.

RESULTS

The quantity of CEA in columnar, goblet mucous, and undifferentiated cells, as well as in the glycocalyx on the surface of the mucosa and in the crypts' content increased proportionally with the intensity of epithelial dysplasia. In inflammatory-regenerative lesions, CEA was located in the apical and supranuclear part of the cytoplasm, and in the dysplastic mucosa, in lateral and basal parts of the cells.

CONCLUSION

The quantity of immunohistochemically demonstrable CEA and its intracellular distribution changed in the colon mucosa during the transition from regenerative to dysplastic epithelial lesions. The intensity of CEA expression was closely related to the intensity of dysplastic lesion.